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Anomalies and Curiosities of Medicine

Anomalies and Curiosities of Medicine is just what it sounds like - a review of the literature, back to Hippocrates in some cases, of bizarre, unusual, and unfortunate medical conditions. It was published in 1896 and so is available as a Gutenberg etext. (Project Gutenberg is dedicated to making electronic versions of public-domain books. The link above is to my mirror of this particular book.)

Some of this stuff is very definitely false, in an "I can't believe Victorians believed that!" sort of way; some is definitely true; and most of the stuff in between is hard to believe, but who knows? Science can be stranger than fiction. I'd love to hear from physicians or others in the know as to whether, say, it's possible for a woman to vomit up fetuses. Until then, I'm not going to make fun of any but the truly ridiculous claims. Please note that when I provide a link, I'm not linking to a part of the text - I trust you can read along yourself if you'd like - but to websites on that topic.

I have illustrations! It will be a while before I get them scanned, though. There are over 300 illustrations. This is both good news and bad news. :-)

One last thing: this is a book about medical anomalies. If you have a weak stomach, you may not want to read this while eating.

ANOMALIES and CURIOSITIES of MEDICINE

Being an encyclopedic collection of rare and extraordinary cases,
and of the most striking instances of abnormality in all branches
of medicine and surgery, derived from an exhaustive research of
medical literature from its origin to the present day,
abstracted, classified, annotated, and indexed.

by GEORGE M. GOULD, A.M., M.D. and WALTER L. PYLE, A.M., M.D.

Table of Contents

• PREFATORY AND INTRODUCTORY

1. GENETIC ANOMALIES [reproductive organs]
2. PRENATAL ANOMALIES [pregnancy]
3. OBSTETRIC ANOMALIES [birth]
4. PROLIFICITY [twins, triplets...]
5. MAJOR TERATA ["freaks"]

PREFATORY AND INTRODUCTORY.

This section gives the justification for writing the book: all mankind has always been interested in the human body, and all mankind has always been interested in, you know, anomalies and curiosities. Furthermore:

Remarkable injuries illustrate to what extent tissues and organs may be damaged without resultant death, and thus the surgeon is encouraged to proceed to his operation with greater confidence and more definite knowledge as to the issue. If a mad cow may blindly play the part of a successful obstetrician with her horns, certainly a skilled surgeon may hazard entering the womb with his knife.

and

We wish, also, to enter a mild protest against the modern egotism that would set aside with a sneer as myth and fancy the testimonies and reports of philosophers and physicians, only because they lived hundreds of years ago. We are keenly appreciative of the power exercised by the myth-making faculty in the past, but as applied to early physicians, we suggest that the suspicion may easily be too active.

Heh. We shall see.

CHAPTER I. GENETIC ANOMALIES.

Ah, genetic anomalies. Gould and Pyle begin by discussing menstruation: what a horrible horrible thing it is. Um, was. Because we know better now, right? The reader is treated to a number of ancient myths and beliefs about all the things a menstruating woman can kill or destroy just by looking at them. Then again, to some cultures it had sacred and magical properties. Where did the menstruation-is-evil belief come from?

Empiricism had doubtless taught the ancient husbands the dangers of sexual intercourse during this period, and the after-results of many such connections were looked upon as manifestations of the contagiousness of the evil excretions issuing at this period. Hence at one time menstruation was held in much awe and abhorrence.

Wait, what dangers?

As the advances of physiology enlightened the mind as to the true nature of the menstrual period, and the age of superstition gradually disappeared, the intense interest in menstruation vanished, and now, rather than being held in fear and awe, the physicians of to-day constantly see the results of copulation during this period.

Results of copulation during this period? What results would those be? I haven't found out. This seems to suggest that the belief is that children conceived during menstruation would be deformed in some way. (If anybody can shed more light on this, I'd appreciate it).

Finally we get to the anomalies of menstruation. Vicarious menstruation, they call it:

Lheritier furnishes the oft-quoted history of the case of a young girl who suffered from suppression of menses, which, instead of flowing through the natural channels, issued periodically from vesicles on the leg for a period of six months, when the seat of the discharge changed to an eruption on the left arm, and continued in this location for one year; then the discharge shifted to a sore on the thumb, and at the end of another six months again changed, the next location being on the upper eyelid; here it continued for a period of two years.

Yes, they have accounts of women menstruating from all these places, as well as from the eyes, nose, fingers, gums, arms, buttocks, back, armpits, scalp, tongue, several other places, and breasts. Especially the breasts.

There's more, of course. Menstruation after a hysterectomy. Menstruation after death. Menstruation in men. Vicarious menstruation in men. Menstruation during pregnancy. Menstruation in women as old as 91 and as young as three days. Girls born with breasts and pubic hair, for that matter, and girls who gave birth as young as 8. On the other hand, of course, are women giving birth in advanced age, up to 73. Then we have women who conceive and bear children through unusual routes - through the rectum, for instance - and descriptions of "superfetation" - double pregnancy and fraternal twins with different fathers, as well as do-it-yourself artificial insemination, as practiced both on women and on dogs.

CHAPTER II. PRENATAL ANOMALIES.

First, extrauterine (ectopic) pregnancy. For some reason they start this out with instances of lithopedion - a retained calcified fetus. Seems to me that being calcified and being in the uterus aren't mutually exclusive, but maybe there's something they're not telling us.

So, on to the ectopic pregnancy: ovary, vagina, etc. But just when it starts to get boring:

In Germany, in the seventeenth century, there lived a woman who on three different occasions is said to have vomited a fetus. The last miscarriage in this manner was of eight months' growth and was accompanied by its placenta. The older observers thought this woman must have had two orifices to her womb, one of which had some connection with the stomach, as they had records of the dissection of a female in whom was found a conformation similar to this.

Discharge of the fetal bones or even the whole of an extrauterine fetus by the rectum is not uncommon.

Bartholinus and Rosseus speak of fetal bones being discharged from the urinary passages. Ebersbach, in the Ephemerides of 1717, describes a necropsy in which a human fetus was found contained in the bladder.

Modern instances of the discharge of the extrauterine fetus from the walls of the abdomen are frequently reported. ... Kimura, quoted by Whitney, speaks of a case of extrauterine pregnancy in a Japanese woman of forty-one ... in which an arm protruded through the abdominal wall above the umbilicus and the remains of a fetus were removed through the aperture.

Also, pregnancies with one baby in the uterus and one outside; extrauterine pregnancies that die and hang out in the abdomen (or wherever) for years and years. Photos here!

Starkey Middleton read the report of a case of a child which had been taken out of the abdomen, having lain there nearly sixteen years, during which time the mother had borne four children. It was argued at this time that boys were conceived on the right side and girls on the left, and in commenting on this Middleton remarks that in this case the woman had three boys and one girl after the right fallopian tube had lost its function.

They note that a woman can retain a dead fetus for 60 years. What about a live one?

Many instances of the exhibition of fetal movements in the bellies of old negro women have been noticed by the lay journals, but investigation proves them to have been nothing more than an exceptional control over the abdominal muscles, with the ability to simulate at will the supposed fetal jerks. One old woman went so far as to show the fetus dancing to the music of a banjo with rhythmical movements.

That said, how about the longest and shortest pregnancies resulting in living children? Longest seems to be a 16-month pregnancy resulting in a 13-pound baby. Some babies born several months premature lived a few days, but it seems there were children who lived (years) after being born with as little as six months' gestation.

The incubator seems destined to be the future means of preserving these premature births. Several successful cases have been noticed, and by means of an incubator Tarnier succeeded in raising infants which at the age of six months were above the average.

Then another fun one: "unconscious pregnancy", where women call the doctor for a stomachache and turn out (surprise!) to be having a baby. I think I saw that on Oprah once. [Update: it happened to someone I know!] Of course, if you write about pregnancy without symptoms of pregnancy, you have to have the symptoms of pregnancy without an actual baby present. Many examples.

In 1646 a woman, after having laughed heartily at the jests of an ill-bred, covetous clown, was seized with various movements and motions in her belly like those of a child, and these continued for over a month, when the courses [menstruation] appeared again and the movements ceased. The woman was certain that she was pregnant.

Alright, so women get morning sickness without being pregnant. Men too! But surely actual pregnant women have interesting symptoms too. How about the "perverted appetites and peculiar longings of pregnant women"? Pickles? Ice cream?

Several writers have seen avidity for human flesh in such females. Fournier knew a woman with an appetite for the blood of her husband. She gently cut him while he lay asleep by her side and sucked blood from the wounds--a modern "Succubus." Pare mentions the perverted appetites of pregnant women, and says that they have been known to eat plaster, ashes, dirt, charcoal, flour, salt, spices, to drink pure vinegar, and to indulge in all forms of debauchery. Plot gives the case of a woman who would gnaw and eat all the linen off her bed.

So much for the mildly amusing. We've now come to the part you've been waiting for, one of the silliest Victorian superstitions, the phenomenon that made the elephant man and that might be summed up as "Genetics? Pshaw!" ... Maternal Impression! Our authors don't seem to be totally convinced, but provide plenty of examples anyway. I don't think I can do justice to the topic except through quotes:

Hippocrates saved the honor of a princess, accused of adultery with a negro because she bore a black child, by citing it as a case of maternal impression, the husband of the princess having placed in her room a painting of a negro, to the view of which she was subjected during the whole of her pregnancy. Then, again, in the treatise "De Superfoetatione" there occurs the following distinct statement: "If a pregnant woman has a longing to eat earth or coals, and eats of them, the infant which is born carries on its head the mark of these things."

Van Helmont cites the case of a tailor's wife at Mechlin, who during a conflict outside her house, on seeing a soldier lose his hand at her door, gave birth to a daughter with one hand, the other hand being a bleeding stump;

The Lancet speaks of ... an infant with fins as upper and lower extremities, the mother having seen such a monster; and another, a child born with its feet covered with scalds and burns, whose mother had been badly frightened by fireworks and a descending rocket.

Graham describes a woman of thirty-five, the mother of seven children, who while pregnant was feeding some rabbits, when one of the animals jumped at her with its eyes "glaring" upon her, causing a sudden fright. Her child was born hydrocephalic. Its mouth and face were small and rabbit-shaped. Instead of a nose, it had a fleshy growth 3/4 inch long by 1/4 inch broad, directed upward at an angle of 45 degrees. The space between this and the mouth was occupied by a body resembling an adult eye. Within this were two small, imperfect eyes which moved freely while life lasted (ten minutes). The child's integument was covered with dark, downy, short hair.

Copeland mentions a curious case in which a woman was attacked by a rattlesnake when in her sixth month of pregnancy, and gave birth to a child whose arm exhibited the shape and action of a snake, and involuntarily went through snake-like movements. The face and mouth also markedly resembled the head of a snake.

The teeth were situated like a serpent's fangs. The mere mention of a snake filled the child (a man of twenty-nine) with great horror and rage, "particularly in the snake season."

Mastin of Mobile, Alabama, reports a curious instance of maternal impression. During the sixth month of the pregnancy of the mother her husband was shot, the ball passing out through the left breast. The woman was naturally much shocked, and remarked to Dr. Mastin: "Doctor, my baby will be ruined, for when I saw the wound I put my hands over my face, and got it covered with blood, and I know my baby will have a bloody face." The child came to term without a bloody face. It had, however, a well-defined spot on the left breast just below the site of exit of the ball from its father's chest.

There is paternal impression, too, which seems to have far fewer anecdotes behind it. Next up is telegony - "Genetics, pshaw!" part two. It goes a little something like this:

In the year 1816 Lord Morton put a male quagga [zebra] to a young chestnut mare of 7/8 Arabian blood, which had never before been bred from. The result was a female hybrid which resembled both parents. During the two following years she had two foals [by an Arabian horse] which Lord Morton thus describes: "They have the character of the Arabian breed as decidedly as can be expected when 15/16 of the blood are Arabian, and they are fine specimens of the breed; but both in their color and in the hair of their manes they have a striking resemblance to the quagga. Both are distinguished by ... the dark stripes across the forehand, and the dark bars across the back part of the legs."

After a half-dozen examples in various farm animals, we get the accounts of telegony in man. This occurs mostly when a black couple has a white-looking baby or vice-versa: since it can't be the husband's child, it's the sperm (uh, "germ") of the mother's previous husband, still at work after all these years.

Dr. Middleton Michel gives a most interesting case in the American Journal of the Medical Sciences for 1868: 'A black woman, mother of several negro children, none of whom were deformed in any particular, had illicit intercourse with a white man, by whom she became pregnant. During gestation she manifested great uneasiness of mind, lest the birth of a mulatto offspring should disclose her conduct. . . . It so happened that her negro husband possessed a sixth digit on each hand, but there was no peculiarity of any kind in the white man, yet when the mulatto child was born it actually presented the deformity of a supernumerary finger.'

Telegony may, they say, be simply a form of maternal impression - it occurs when the mother thinks more about the previous husband than the current one.

What next? the transmission of contagious disease to the fetus in utero - boring. the effects on the fetus in utero of medicine administered to the pregnant mother - boring. Intrauterine amputations (eg, child born missing a limb) - still kinda boring. Ah, here we go: fetal injuries.

Carhart describes the case of a pregnant woman, who, while in the stooping position, milking a cow, was impaled through the vagina by another cow. The child was born seven days later, with its skull crushed by the cow's horn. The horn had entered the vagina, carrying the clothing with it.

There are some marvelous cases of recovery and noninterference with pregnancy after injuries from horns of cattle.

I think we'll pass on the rest of those. Most involve abdominal injuries in which intestines leave the body and are returned, occasionally with the use of anaesthetic.

Word of the day: epiploon. Another name for the greater omentum. Try to work this one into conversation today.

As promised, many stories are told and conclusions drawn about the effects of various injuries and surgeries on pregnant women. Most cause no harm to the fetus, so doctors are encouraged to do what they please as long as they stay away from polyps. Also:

The causes [of abortion, ie miscarriage] that are observed every day, such tight lacing, excessive venery, fright, and emotions, are too well known to be discussed here.

Ah, the days when lust and tight corsets were common causes of medical problems. But, on with the fetuses.

Crisp says of a case of labor that the head of the child was obstructed by a round body, the nature of which he was for some time unable to determine. He managed to push the obstructing body up and delivered a living, full-term child; this was soon followed by a blighted fetus, which was 11 inches long, weighed 12 ounces, with a placenta attached weighing 6 1/2 ounces. It is quite common for a blighted fetus to be retained and expelled at term with a living child, its twin.

Apparently a fetus secretes a hormone - the name of which I cannot hunt down at the moment - that is essentially a message saying "I'm still here, don't abort me". When it dies, it stops sending that message and is aborted or absorbed. With twins, however, when one dies the other is still sending that message, and the dead one hangs out for as long as the living one is there. (Read that one in a horse magazine. Somehow I keep searching and everything that turns up is on horses - or, in one case, golden lion tamarin monkeys. Internet, I may never understand you.)

Anyway, let's have one last fetus story before we move on:

Pare mentions Lycosthenes' account of a woman in Cracovia in 1494 who bore a dead child which had attached to its back a live serpent, which had gnawed it to death. He gives an illustration showing the serpent in situ. He also quotes the case of a woman who conceived by a mariner, and who, after nine months, was delivered by a midwife of a shapeless mass, followed by an animal with a long neck, blazing eyes, and clawed feet.

CHAPTER III. OBSTETRIC ANOMALIES.

I thought we had been reading about obstetric anomalies!

It seems strange that a physiologic process like parturition should be attended by so much pain and difficulty. ... We read of the ancient wild Irish women breaking the pubic bones of their female children shortly after birth, and by some means preventing union subsequently, in order that these might have less trouble in child-birth--as it were, a modified and early form of symphysiotomy.

yowch.

Remember "unconscious" pregnancy? There's unconscious labor, too. These are stories of women who gave birth without really noticing - often in their sleep. Typically they wake up before the baby is fully out. Choice quote:

About 4 A.M. the husband of the girl, in great fright, summoned the physician,saying: "Monsieur le Medecin, il y a quelque chose entre les jambes de ma femme," ["Doctor, there's something between my wife's legs!"] and, to Dr. Case's surprise, he found the head of a child wholly expelled during a profound sleep of the mother.

In other anecdotes, women give birth (awake) without making a big deal of it:

Harvey relates a case, which he learned from the President of Munster, Ireland, of a woman with child who followed her husband, a soldier in the army, in daily march. They were forced to a halt by reason of a river, and the woman, feeling the pains of labor approaching, retired to a thicket, and there alone brought forth twins. She carried them to the river, washed them herself, did them up in a cloth, tied them to her back, and that very day marched, barefooted, 12 miles with the soldiers, and was none the worse for her experience. The next day the Deputy of Ireland and the President of Munster, affected by the story, to repeat the words of Harvey, "did both vouchsafe to be godfathers of the infants."

In the paragraphs that follow, we learn, among other things, of cases of birth by the rectum. Some have complained that my summary is nauseating enough as it is, so let's leave birth-by-the-rectum out of it. Still, there is this:

Hunter speaks of a case of pregnancy in a woman with a double vagina, who was delivered at the seventh month by the rectum.

Mother (to child): "Most babies are happy just to have one vagina to go through! I gave you two! Two vaginas, but no! You had to go out through the rectum!"

In another of the cases, the uterus ruptured into the "culdesac", which for word-of-the-day purposes, I looked up. The easiest way to describe it is with a picture such as this one: it's just the area inside the body between the uterus/vagina and the colon/rectum. The term cul-de-sac, as applied either here or to a suburban street, literally means "back end of sack" (I used to tell my brother we lived on a "bag-butt" street, which may be a closer translation) and anatomically refers to any pouch, but especially this one.

Deliveries from a variety of other openings are discussed, and then delivery by dead women.

Reiss records the death of a woman who was hastily buried while her husband was away, and on his return he ordered exhumation of her body, and on opening the coffin a child's cry was heard. The infant had evidently been born postmortem. It lived long afterward under the name of "Fils de la terre." ["son of the earth"]

There is also this account:

Valerius Maximus says that while the body of the mother of Gorgia Epirotas was being carried to the grave, a loud noise was heard to come from the coffin and on examination a live child was found between the thighs,--whence arose the proverb: "Gorgiam prius ad funus elatum, quam natum fuisse."

It seems there are no online latin-to-english translators that can handle this, so I have to take my own stab at the translation; this is especially difficult since I don't know any Latin. The best I can do is "Before you bury someone, check them for babies". Sound advice, anyway. (a better guess: "Gorgia was about to be buried, when he was born". Any latin professors out there?)

Ceasar was not actually delivered by ceserean section - the Straight Dope explains this and gives some history of the procedure, including its first surviving mother (1500, by a Swiss pig gelder). Still, the history of cesereans with a single survivor is long:

After Zeus burnt the house of Semele, daughter of Cadmus, he sent Hermes in great haste with directions to take from the burnt body of the mother the fruit of seven months. This child, as we know, was Bacchus.

You can't say the authors weren't thorough in their search of the literature. They also hypothesize that Macduff was "from his mother's womb untimely ripp'd" by... "cattle-horn". They won't shut up about that cattle-horn story, will they? Also, they assert that "the celebrated case" was "performed by Jacob Nufer, a cattle gelder", not a pig gelder. So maybe Cecil was wrong. Anyway, the third successful American C-section was performed on a rachitic dwarf, whose pelvis had only an inch-wide opening. Mother and child both survived, though (as is fairly common in these stories) the baby died later, of other causes. Also discussed is the "first successful Ceserean section for double monstrous conception in America", that is, the first c-section delivery of conjoined (siamese) twins where the mother lived. The twins, in this case, were stillborn. Also:

Instances of repeated Cesarean section were quite numerous, and the pride of the operators noteworthy, before the uterus was removed at the first operation, as is now generally done.

Why the uterus was generally removed, they don't say. Perhaps to prevent future pregnancies in a woman with such difficult anatomy? But next up, we have cesereans done ...

In Uganda:

The young girl was operated on in the crudest manner, the hemorrhage being checked by a hot iron. The sutures were made by means of seven thin, hot iron spikes, resembling acupressure-needles, closing the peritoneum and skin. The wound healed in eleven days, and the mother made a complete recovery.

by the mother:

There is an interesting account of a poor woman at Prischtina, near the Servian frontier, who, suffering greatly from the pains of labor, resolved to open her abdomen and uterus. She summoned a neighbor to sew up the incision after she had extracted the child, and at the time of report, several months later, both the mother and child were doing well.

and, of course, by cattle-horn.

Pigne speaks of a woman of thirty-eight, who in the eighth month of her sixth pregnancy was gored by a bull, the horn effecting a transverse wound 27 inches long, running from one anterior spine to the other [ie, from her backbone all the way around her waist to the other side of her backbone]. The woman was found cold and insensible and with an imperceptible pulse. The small intestines were lying between the thighs and covered with coagulated blood. In the process of cleansing, a male child was expelled spontaneously through a rent in the uterus. The woman was treated with the usual precautions and was conscious at midday. In a month she was up. She lived twenty years without any inconvenience except that due to a slight hernia on the left side. The child died at the end of a fortnight.

A similar case from 1647 is illustrated with an engraving of a bull tossing a woman up into the air, with her shoe and a baby simultaneously falling down. Also related are tales of cesarean by ox, by cannonball, and after death.

CHAPTER IV. PROLIFICITY.

Prolificity! That's when you have more than one baby at a time, right?

The old Celts were so jealous of their vigor that they placed their babes on a shield in the river, and regarded those that the waves respected as legitimate and worthy to become members of their clans. In many of the Oriental countries, where the population is often very excessive and poverty great, the girl babies of the lower classes were destroyed. At one time the crocodiles, held sacred in the Nile, were given the surplus infants.

Oh, and overpopulation. Right. And infanticide. Let's see those quintuplets already, OK?

The old explanation of the causation of the remarkable exceptions to the rules of prolificity was similar to that advanced by Empedocles, who says that the greater the quantity of semen, the greater the number of children at birth. Pare, later, uses a similar reason to explain the causation of monstrosities,

Monstrosities? We're getting ahead of ourselves - that's the next chapter. In fact, this whole chapter is short and boring. Let's skim, shall we?

The celebrated case of Countess Margaret ... She was at this time forty-two years of age, and at one birth brought forth 365 infants, 182 males, 182 females, and 1 hermaphrodite. They were all baptized in two large brazen dishes by the Bishop of Treras, the males being called John, the females Elizabeth. During the last century the basins were still on exhibition in the village church of Losdun, and most of the visitors to Hague went out to see them.
...
Authentic records of 5 and 6 at a birth are extremely rare and infinitesimal in proportion. The reputed births in excess of 6 must be looked on with suspicion, and, in fact, in the great majority of reports are apochryphal.

It would have been more fun for the 365-lets to have been real. Hmph. Instead of dwelling on our disappointment, though, let's puzzle over this:

They weighed at birth in the aggregate 19 1/2 pounds without clothing; the first weighed 6 pounds; the second 5 pounds; the third 4 1/2 pounds; the fourth 4 pounds. Mrs. Page is a blonde, about thirty-six years old, and has given birth to 14 children, twins three times before this, one pair by her first husband. She has been married to Page three years, and has had 8 children in that time. I have waited on her each time. Page is an Englishman, small, with dark hair, age about twenty-six, and weighs about 115 pounds.

Why they need to note the hair color of each of the parents, I have no idea. Victorian beliefs about hair color and fertility? What could it be?

Within a year after her marriage [a lady] gave birth to twins; in the next year to triplets; in the third year to quadruplets; in the fourth year to quintuplets, and in the fifth year bore sextuplets; in this last labor she died.

Just think if she'd have kept going!

In illustration we may note the following: In the Illustrated London News, May 11, 1895, is a portrait of "Lady Millard," a fine St. Bernard bitch, the property of Mr. Thorp of Northwold, with her litter of 21 puppies, born on February 9, 1896, their sire being a magnificent dog--"Young York." There is quoted an incredible account of a cow, the property of J. N. Sawyer of Ohio, which gave birth to 56 calves, one of which was fully matured and lived, the others being about the size of kittens; these died, together with the mother. There was a cow in France, in 1871, delivered of 5 calves.

Good to know. On to the Major Terata!

Chapter V. MAJOR TERATA

Wouldn't Major Terata be a great name for a band? Or, better yet, a comical military character. He's probably Colonel Mustard's brother.

Terata, of course, are "monsters", and the field of their study is Teratology, which can be viewed in soft focus on calm, soothing, sensitive turquoise backgrounds both in America and in Europe. Gould and Pyle, we'll find, know nothing of soothing turquoise backgrounds.